Managing Dual Practice of Health Workers: Evidence from Indonesia
50 Pages Posted: 6 Aug 2020 Last revised: 16 Nov 2022
Date Written: November 8, 2022
Abstract
This paper analyses the causal effects of private practice of public health workers on public health provision in Indonesia. We exploit the exogenous variation in the initiation of private practice after the 1997 Ministry of Health regulation 916 that required health professionals to apply for a license for private practice after at least three years of compulsory service after graduation. Instrumental variables (IV) estimates, built around the cut-off experience of 3 years after 1997, suggest that dual practitioners (relative to those engaged in public puskesmas only) work significantly less hours per week, but see significantly more patients in public facilities. Results hold even after we drop the defiers. We rule out the influence of unobserved confounding factors like workers’ ability and attribute these results to dual practice rather than higher efficiency of dual practitioners. Finally, observed effects are worse when the private practice is held away from the puskesmas.
Note:
Funding Information: MISSING
Conflict of Interests: MISSING
Keywords: Dual Practice of Health Professionals, Indonesia, Ministry of Health Regulation 916, Weak Monitoring, Difference-in-Difference Regression Discontinuity Design
JEL Classification: I10, I18, J2, J44, J45, O1
Suggested Citation: Suggested Citation